Tuesday, February 26, 2013

I'm not sure it's possible to live with diabetes, but without issues surrounding food or our bodies.

Food is never just food - it's medicine; it's a math equation; sometimes it's the enemy. The numbers on our glucose meters and on our medical charts often dictate, or reveal, our behavior. Are we skipping meals because we don't want to mess up that pretty little CGM line? Are we inhaling cereal at 2:00 am to bring us out of the sweaty, confusing haze of low blood sugar? (Really, who else inhales cereal but a PWD with a low BG?) How about the times we skip the healthy food - the fruit, the whole grains - because the low carb (but less healthy) options will wreck less glucosey havoc? (I'm looking at you, piles of bacon.)

And what about the times we binge - either mindfully or mindlessly - only to frantically attempt to carb guess and bolus accordingly afterwards?

Growing up with type 1 diabetes, there were many things on the "nope" list. Hungry? Okay, you can only eat these things, in these amounts, at this time. Not hungry? Too bad - you have to eat these exact things anyway. Hostess products stayed on the top shelves of our pantry, out of my reach but rarely out of my sight. I'd linger there, leaning on the door and gazing with affection at all of the things I couldn't eat in whatever quantity I wanted to.

Now that I'm an adult capable of making my own decisions (and wearing an insulin pump that allows me the kind of foody freedom I never got to have as a kid), things get a little sticky. The cumulative power of "no" sometimes feeds an irrational sense of being owed; like I need to eat the things I couldn't eat previously to somehow make up for lost time. As if, somehow, I'm sticking it to diabetes by doing so - when, if anything, I'm only sticking it to myself.

Food issues? Yes. Yes, I absolutely have those.

The thing is, I know I'm not alone - many of us experience a tangled relationship with what and how and how much we eat. This week, February 24th through March 2nd, is National Eating Disorder Awareness Week (#NEDAwareness if you're Twittery) and the Diabetes Advocates organization is striving to "broaden and amplify the conversation on diabetes-related eating disorders by offering information and resources to the diabetes community, including those at risk and those in need of support", and I fully support this mission. This post on the DA site offers some great resources to check out, and I urge you to pass them onto others.

Friday, February 22, 2013

At the end of last month I made a fairly important update to this site's disclosure policy, but I know that unless this is your first time here, you're probably not reading that puppy very often. And so, in the spirit of transparency and "things I think you should know about me", I'd like to elaborate on it a bit.

At the end of last year, a guy who had an idea for a new health startup contacted me to see if I'd be interested in being a part of the diabetes side of it. We've had some really good conversations, and the more I think about what this idea can become, the more excited I am that I get to be part of it. That's a good thing, too, since I signed a short-term consulting contract (read: they're paying me) with them last month. (!)

Because the company is so new and still finding its identity/brand/mission/whatevs, it's hard to specify just what exactly my role is there yet, but I can tell you this much and hope to have more information for you soon: the company is called Whitewater Health, and we're creating personal information platforms for people living with chronic disease. Diabetes is the first "thing" we're working on, and I feel very lucky to be part of this - and I hope the relationship can continue for quite some time.

This is something that I'm doing part-time for now, from home, in addition to my regular full-time job, so things have gotten a little busier around here! And if the relationship changes or when I'm finally able to elaborate a bit, you guys will be the first to know. It's important to me that I make clear the relationships I have with those in the diabetes industry to you guys - everyone has biases, and I don't feel I'm doing things the right way if I don't disclose what mine are.

So there you are, and Happy Friday. (Aaron and I - okay, mostly Aaron - will be digging ourselves out of several inches of snow this morning - who's ready for spring??!)

Monday, February 18, 2013

It's that glamorous and elegant time of year where I have to collect all of my pee for 24 hours into a plastic jug, and then try to discreetly transport it in a tote bag to the hospital lab while hoping no one notices the slooshing sound as I briskly walk the hallways.

Wednesday, February 13, 2013

I'm still feeling good - so good in fact that I often feel badly when I'm asked, "so, how are you feeling?" (often delivered with that concerned and empathetic eyebrow-squishing move - you know the one, right?), because I feel as though I should meet their concern with reason for it - and there is none. No nausea. Little to no food aversion (though Aaron's chinese food the other night did leave me thinking that I'd never eat sesame chicken again, if given the choice), and no weird food cravings. It's just been more of the same - a tendency to run low if anything, a pleasing ability to bolus right as I begin eating (as opposed to pre-bolusing 15 minutes ahead, which is my norm), and a general case of sleepyheadedness.

And we can now add "epic pregnancy-induced clumsiness" to the list.

Clockwise, from top left: beginnings of baby bump; a "good" day; a "what the hell happened" day; my broken heart.

Yesterday, somehow, I managed to drop my phone iBGStar-first into the dog's food dish. As a friend put it, it seemed to have landed on its self-destruct button, because it busted into a bunch of unrecognizable and unsalvageable pieces. (Actually, I just think it's the weight of the phone - and landing in a ceramic dish - that did it, but I like the other imagery better.) I've been finding the iBGStar app data and charts immensely useful during pregnancy, so I was disheartened to lose it. I'm using my Verio IQ in the meantime (a fine meter itself), and I found out this morning that Sanofi will send me a replacement iBGStar, so my data withdrawal symptoms should only last for another 24 hours or so. Woo!

I'm also noticing some old wives tales rearing their heads - if you can believe those sorts of things - which has Aaron and I (and all of our families) guessing the gender. We will be able to find out at my OB appointment next month, and I don't know how I'm going to be able to wait that long.

In the meantime, I'll be eating fruit by the foot (as in amount, not the candy, because gross) and restraining myself from buying any more gender-neutral footed onsies.

Monday, February 11, 2013

(Alternate titles to this post: "Following Your Every Move [But Not In A Creepy Way]", "Stalking Has Never Been So Healthy", "Maybe I Should Just Get On With The Post Already")

I remember seeing the name "Ginger.io" at the Stanford Medicine X conference last September, but never really got a chance to find out what (or who?) it was. I made a mental note to Google it later, but never did... which meant I was really glad to see an email from them a couple of weeks back, explaining what they're all about. I think what they're working on is a really cool concept and could help a lot of people (and requires minimal effort from the user to gain the benefits), so I wanted to help spread the word.

[Kim]: Can you tell us a little about what Ginger.io is, and how it got started?

[Peter of Ginger.io]: Sure, Ginger.io is a small startup on a big mission to change how people living with chronic conditions connect through health information — using just an iPhone or Android phone. Our application uses the sensors in your smartphone to map the relationship between your behavior and your health — and turn it into insights.

Ginger.io is based on research that came out of MIT’s Media Lab, where Anmol, our co-founder, was pursuing a PhD in computer science with a focus in modeling human behavior patterns. While at MIT Anmol met Karan, our other co-founder and an MBA with a deep knowledge of the health care system, and together they set out to build a check engine light for human health.

How does the whole thing work, and how much information do you have to share with the Ginger.io app?

For the first month or two, we’ll focus on collecting data and learning how your condition affects your behavior. Once we have your behavior baseline, we’ll start delivering personalized health insights, provide insights into how the study community is doing, and allow you to better connect with your care team by alerting them when something seems out of place.

So what type of data do we collect? The first type is active data - this data is short surveys that our application will ask you to answer periodically. They are easy to fill out and ask general questions around your mood, exercise behavior, etc. The second type of data we collect is passive data through sensors in your smartphone. Passive data is general patterns around your calling, texting, and movement behavior. Our system does not collect any specifics (i.e. who you are talking to, what you said, where you went). All we gather is general patterns like “how many calls did you make yesterday” and “how far did you travel”. All of your data is fully HIPAA compliant and treated just like a medical record at the doctor’s office.

Sounds legit. So why do you think this will be helpful for people living with diabetes? What value will patients get out of using the app?

Many people living with diabetes often feel overwhelmed at the sheer amount of things they need to keep track of. Ginger.io tries to track behavior with minimal effort on the participants side and help them get the support they need when they need it. Participants will receive:

Personal insights into their health patterns — right away

Improved connection to their care team (after the first couple of months you can set up alerts to be delivered to your care team when something seems out of place)

Satisfaction that they’re contributing to science to benefit the diabetes community

Is this for people with all types of diabetes?

Our current study is targeting those with type 2 diabetes but we plan to release a version of the application for pre-diabetes and type 1 diabetes in the future. As such, we encourage anyone living with diabetes to sign up for the program and we’ll get them on the app whenever possible. [Editor's note: I downloaded the app a couple of weeks ago and while it's intended for people living with type 2 at this time, it has pointed out how far I'm traveling each day which is kind of nerdy cool and interesting.]

This Valentine's Day, the diabetes community can help the Life for a Child program, sponsored by the International Diabetes Federation, which aims to take “contributions from donors [to] go to established diabetes centers enabling them to provide the ongoing clinical care and diabetes education these children need to stay alive.” The idea is to take the typical “dozen roses,” so popular on Valentine’s Day, and save just one rose to spare the life of a child. “Spare a Rose, Save a Child” is simple: buy one less rose this Valentine’s Day and share the value of that flower with a child with diabetes in the developing world. Your loved one at home still gets flowers, and you both show some love to someone who needs it.

Want to help spread the word? Here's what you can do:

This week, February 10 - 16, spread the word through your blog, Facebook, Twitter (use the hashtag #sparearose), Google+, Tumblr, or your menagerie of carrier pigeons about the "Spare a Rose, Save a Child" idea, which will also help raise awareness of the Life for a Child program. (And if you do post about this effort, please leave a comment on Kerri's blog post so that everything can be kept track of.)

If you're so inclined, download one of these images to use in your post, on your site, as your social media avatar, whatevs, during this week: Banner 1, Banner 2, Banner 3.

Please use the URL: http://bit.ly/SpareRoseSaveChild to link to the IDF site. (This is a short URL created to see how much impact our social media campaign has generated.) For more information on the Life for a Child program, please check out that link.

Let's help spread the love offline to those in our diabetes community that most need it.

Wednesday, February 6, 2013

Why do most maternity pants not have functional pockets? I've never felt so let down by a garment of clothing. Do designers believe that pregnant women have no further need to carry small items around with them? Do they expect us to just shove everything in the stretchy tummy fabric and look as though we're growing a robot of some sort in our bellies? My insulin pump most comfortably resides in my pants pocket, sirs. Please fix this.

Is being pregnant like being cured? I'm beginning to think so, because the amount of carbs I'm eating might make even Adam Richman raise an eyebrow. Hungry Hungry Hippos don't even snack this often.

I miss (caffeinated) coffee. I miss coffee like Champ misses Ron. I've been crashing around 9:30 pm most nights (!) and taking naps left and right. I miss your musk, Ron.

Never has an embellished CGM beep been so annoying. "You're under 55! Wake up!" (I do; I test; 75 mg/dL.) "You... are a jerk. And wrong. Please stop, and let me sleep." And so on. Every night, nearly. It's hard to maintain a fasting bg of between 65 and 95 when your CGM threshold is 60 and it seems prone to overreacting.

Have I mentioned that I miss coffee?

It's one item on a long list of "things to avoid that I rather enjoy": smoked or cured meats (meaning: bacon, some ham, breakfast sausage, the salmon in some cooked sushi... pretty much all of the good stuff), cold cut sandwiches, anything with raw-ish eggs (most Caesar dressings, hollandaise sauce), and the obvious: alcohol. Pretty sure that once August comes and goes, I will be washing a bacon Eggs Benedict down with some wine.

It's all worth it, mind you, but it's an adjustment I haven't been looking forward to making. And now it's here, and now I need a nap.

Monday, February 4, 2013

Now that I'm in the process of turning food into a tiny human, I've been told by my endo that I need to start entering all of my blood test results into my insulin pump. At first I was miffed about having to do an additional step (several times a day) on top of all the other steps I'm already doing, but when we had to print off separate charts for my Ping stuff, my iBGStar readings, and my Dexcom graphs and charts, I realized what a pain in the ass I was being if I didn't help her out just a little.
Besides, it's not like she's making me use the Ping remote meter for testing again - while I like my insulin pump, I can do without that chunky, clunky, fat snail of a meter. The iBGStar app provides a lot of meaningful information for me, and going back to life without it... well, I don't want to.

But what this does mean is that I now have one more thing to carry around everywhere; one more accessory sitting on my desk during my workday. They all have cases (because, hi, that's what I do), and while they don't match, it makes me feel slightly better about needing to have so many carry-on items.

Clockwise from top left: a Vera Bradley wallet (modified like so); Fossil cosmetic case that houses all of my
meter crap, an extra pump site, a Humalog pen and needles; Tallygear case for the Dexcom G4
(disclosure: I was sent one free to try out); the bottom of my iBGStar phone case.

Disclaimer.

I have absolutely no medical training of any kind. Nothing on this website should be used as medical or legal advice. Please talk to your physician first before making any changes to anything related to your health.